Time-course effect of a single dose of hydrocortisone for refractory hypotension in preterm infants.

MedLine Citation:

PMID:
21429058
Owner:
NLM
Status:
Publisher

Abstract/OtherAbstract:

Objective: To determine the time-course effect of a single dose of HC on arterial blood pressure in extremely low gestational age newborns (ELGANs) with refractory hypotension during the first three days of life. Study design: A matched case-control study of a cohort of 116 infants born between 23 and 27 wks gestation at a tertiary center. Twelve infants (10%) were treated with HC for refractory hypotension (HC group). HC was administered at a dose of 2 mg/kg, when mean arterial pressure (MAP) was below 30 mmHg (25 mmHg for infants <25 wks of GA) despite the use of inotropes and volume expanders. Changes in the MAP after the HC administration were compared with those in the infants who were not treated with HC and matched for gestational age (Control group). Results: The mean MAP before administration of HC was significantly lower in the HC group than that in the control group (24.0 ± 3.2 versus 33.3 ± 4.8 mmHg; p < 0.01). The mean MAP in the HC group increased significantly at 2 h after HC treatment, and then reached levels comparable to those in the control group at 5 h (31.3 ± 4.0 versus 33.9 ± 4.7 mmHg; p = 0.18), and remained at the normal levels until 12 h after HC treatment. Conclusion: A single dose of HC treatment induces a rapid and sustained improvement in blood pressure in ELGANs with refractory hypotension.